The
issue on appeal is whether a left knee arthroscopy and
partial lateral meniscectomy is reasonable and necessary
medical treatment for the compensable injury. On February 23,
2017, the claims administrator denied authorization for the
proposed surgery. The Office of Judges affirmed the claims
administrator in its May 12, 2017, Order. The Order was
affirmed by the Board of Review on October 4, 2017. The Court
has carefully reviewed the records, written arguments, and
appendices contained in the briefs, and the case is mature
for consideration.

This
Court has considered the parties' briefs and the record
on appeal. The facts and legal arguments are adequately
presented, and the decisional process would not be
significantly aided by oral argument. Upon consideration of
the standard of review, the briefs, and the record presented,
the Court finds no substantial question of law and no
prejudicial error. For these reasons, a memorandum decision
is appropriate under Rule 21 of the Rules of Appellate
Procedure.

Mr.
Cooper, a well operator, injured his left knee on August 4,
2016, when he slipped and twisted his knee while he was weed
eating on an incline. He first sought medical treatment on
October 17, 2016, when he was diagnosed with a left knee
sprain. The claims administrator accepted the claim as
compensable for a left knee strain/sprain on November 8,
2016.

A left
knee MRI performed on November 8, 2016, revealed normal
configuration of the anterior and posterior cruciate
ligaments and normal attachment and signal intensity of the
medial and lateral ligamentous complex with normal fluid
collection around the ligaments. There was no evidence to
indicate a bone contusion, displaced fracture, subluxation,
ligament injury, or meniscal tear.

On
November 15, 2016, Mr. Cooper was treated by Jeff Prichard,
PA-C, who noted that Mr. Cooper said his left knee felt
unstable. Mr. Prichard diagnosed a left knee sprain and
referred Mr. Cooper to see Frederick Morgan, M.D. On November
29, 2016, Mr. Prichard diagnosed sprained left knee, took Mr.
Cooper off of work for one month, and referred him to
physical therapy.

Prasadarao
Mukkamala, M.D., performed an independent medical evaluation
on December 21, 2016. Mr. Cooper complained of pain in his
left knee with all levels of activity. Dr. Mukkamala noted
Mr. Cooper walked with a normal gait. He diagnosed a left
knee sprain and opined that no additional medical treatment
was needed.

Dr.
Morgan treated Mr. Cooper for complaints of left knee pain
and swelling on January 16, 2017. Mr. Cooper noted he had
been experiencing anterior lateral pain and swelling since he
twisted his knee on August 4, 2016. He had been treated
conservatively with anti-inflammatory medication, physical
therapy, and quadriceps strengthening. An attempted return to
work was not successful. Prior to this incident, Mr. Cooper
had a 1998 right knee arthroscopy and a 2001 left knee
arthroscopy. A left knee MRI revealed significant effusion
and a lateral meniscus tear. Dr. Morgan's impression was
left knee pain consistent with a lateral meniscal tear. He
recommended a partial lateral meniscectomy. In a February 20,
2017, letter to Mr. Cooper's attorney, Dr. Morgan noted
Mr. Cooper had been treated conservatively and that an MRI
revealed a torn lateral meniscus. Following his evaluation of
Mr. Cooper, Dr. Morgan recommended an arthroscopic evaluation
of the knee with a partial lateral meniscectomy, which had
been denied. Dr. Morgan noted that he had diagnosed a lateral
meniscal tear and opined that the tear was due to Mr.
Cooper's August 4, 2016, injury. In his opinion, the
March 27, 2001, surgery for left knee was totally unrelated
to the current meniscal pathology.

On
January 30, 2017, Dr. Mukkamala completed a supplemental
report in which he stated that Mr. Cooper sustained a soft
tissue injury in the form of a sprained left knee on August
4, 2016. Mr. Cooper continued to work after the injury. He
had a prior injury and surgery on the left knee in 2001. In
Dr. Mukkamala's opinion, the continuing symptoms Mr.
Cooper had were related to the "preexisting
pathology" and not the August 4, 2016, injury. Dr.
Mukkamala opined that it was reasonable for Mr. Cooper to
undergo the proposed surgery but that it was not needed as a
result of his work injury. On February 23, 2017, the claims
administrator denied the request for a left knee arthroscopy
with partial lateral meniscectomy.

Jonathan
Luchs, M.D., performed an age of injury analysis using the
November 8, 2016, MRI film on April 14, 2017. He stated that
the original reader of the MRI noted a normal configuration
of the knee with intact structures, and Dr. Luchs agreed that
there was no evidence of a tear on the film. However, he
noted the film showed chronic ganglion degeneration of the
anterior cruciate ligament; chronic mild thinning of the
patellar apex extending into the medial patellar facet with
medial half of trochlear cartilage thinning and chronic
softening; and mild thinning of the inner aspect of the
medial femoral condylar cartilage. In his opinion, all of the
conditions seen on the MRI were chronic.

Mr.
Cooper testified by deposition on April 17, 2017, that he
worked as a well operator which entailed walking pipelines,
mowing and cleaning locations, and performing maintenance on
the wellheads. He was required to squat, kneel, and climb. He
worked alone. On August 4, 2016, he was standing on a sloped
incline using a weed eater when he slipped, lost his footing,
and twisted his left knee. He felt discomfort in the knee at
the time but thought he had just tweaked his knee. He filled
out an incident report after continued knee pain. He
continued to work until November 1, 2016. He returned to work
in January of 2017, but was only able to work two days due to
his knee pain. He continued to have pain in the middle and
back of his knee.

On May
2, 2017, Mr. Cooper underwent a diagnostic arthroscopy of the
left knee that included debridement of a partial thickness
tear of the anterior cruciate ligament, debridement of the
medial femoral condyle, and debridement of the patella. The
preoperative diagnosis was chronic left knee pain with
possible medial meniscus tear. The postoperative diagnoses
included partial thickness tear of the anterior cruciate
ligament, grade four chondromalacia of the medial femoral
condyle, and grade two and three chondromalacia of the
patella.

The
Office of Judges affirmed the claims administrator's
denial of treatment on May 12, 2017.It determined that the
only compensable condition in the claim was a left knee
sprain. Mr. Cooper failed to show that the left knee
arthroscopy was medically necessary or reasonably required
for the treatment of the compensable condition. It found the
requested treatment was for the lateral meniscus tear, which
was not a compensable condition. It noted that the treating
physician could request the condition be added as a
compensable condition. The Office of Judges determined the
record did not support a finding that the left knee
arthroscopy ...

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